EP3715349A1 - Composé bisdiazabicyclo pour le traitement et/ou la prévention de maladies ou de troubles liés au virus de l'hépatite - Google Patents

Composé bisdiazabicyclo pour le traitement et/ou la prévention de maladies ou de troubles liés au virus de l'hépatite Download PDF

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EP3715349A1
EP3715349A1 EP18881691.2A EP18881691A EP3715349A1 EP 3715349 A1 EP3715349 A1 EP 3715349A1 EP 18881691 A EP18881691 A EP 18881691A EP 3715349 A1 EP3715349 A1 EP 3715349A1
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Prior art keywords
compound
hepatitis
virus
group
disease
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German (de)
English (en)
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EP3715349A4 (fr
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Yifan Zhai
Xiaoyong Zhang
Jinlin Hou
Dajun Yang
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Healthquest Pharma Inc
Jiangsu Ascentage Biomed Development Inc
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Healthquest Pharma Inc
Jiangsu Ascentage Biomed Development Inc
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Publication of EP3715349A1 publication Critical patent/EP3715349A1/fr
Publication of EP3715349A4 publication Critical patent/EP3715349A4/fr
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K45/00—Medicinal preparations containing active ingredients not provided for in groups A61K31/00 - A61K41/00
    • A61K45/06—Mixtures of active ingredients without chemical characterisation, e.g. antiphlogistics and cardiaca
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07D—HETEROCYCLIC COMPOUNDS
    • C07D487/00—Heterocyclic compounds containing nitrogen atoms as the only ring hetero atoms in the condensed system, not provided for by groups C07D451/00 - C07D477/00
    • C07D487/02—Heterocyclic compounds containing nitrogen atoms as the only ring hetero atoms in the condensed system, not provided for by groups C07D451/00 - C07D477/00 in which the condensed system contains two hetero rings
    • C07D487/04—Ortho-condensed systems
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/40—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil
    • A61K31/407—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil condensed with other heterocyclic ring systems, e.g. ketorolac, physostigmine
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/495—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with two or more nitrogen atoms as the only ring heteroatoms, e.g. piperazine or tetrazines
    • A61K31/496—Non-condensed piperazines containing further heterocyclic rings, e.g. rifampin, thiothixene or sparfloxacin
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
    • A61K47/50—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates
    • A61K47/51—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent
    • A61K47/54—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent the modifying agent being an organic compound
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
    • A61K47/50—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates
    • A61K47/51—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent
    • A61K47/54—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent the modifying agent being an organic compound
    • A61K47/55—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent the modifying agent being an organic compound the modifying agent being also a pharmacologically or therapeutically active agent, i.e. the entire conjugate being a codrug, i.e. a dimer, oligomer or polymer of pharmacologically or therapeutically active compounds
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P1/00—Drugs for disorders of the alimentary tract or the digestive system
    • A61P1/16—Drugs for disorders of the alimentary tract or the digestive system for liver or gallbladder disorders, e.g. hepatoprotective agents, cholagogues, litholytics
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P31/00—Antiinfectives, i.e. antibiotics, antiseptics, chemotherapeutics
    • A61P31/12—Antivirals
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P31/00—Antiinfectives, i.e. antibiotics, antiseptics, chemotherapeutics
    • A61P31/12—Antivirals
    • A61P31/14—Antivirals for RNA viruses
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P31/00—Antiinfectives, i.e. antibiotics, antiseptics, chemotherapeutics
    • A61P31/12—Antivirals
    • A61P31/20—Antivirals for DNA viruses
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07D—HETEROCYCLIC COMPOUNDS
    • C07D519/00—Heterocyclic compounds containing more than one system of two or more relevant hetero rings condensed among themselves or condensed with a common carbocyclic ring system not provided for in groups C07D453/00 or C07D455/00
    • Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y02—TECHNOLOGIES OR APPLICATIONS FOR MITIGATION OR ADAPTATION AGAINST CLIMATE CHANGE
    • Y02A—TECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE
    • Y02A50/00—TECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE in human health protection, e.g. against extreme weather
    • Y02A50/30—Against vector-borne diseases, e.g. mosquito-borne, fly-borne, tick-borne or waterborne diseases whose impact is exacerbated by climate change

Definitions

  • the present invention relates to a diazabicyclo compound for the treatment and/or prevention of a disease or disorder associated with a hepatitis virus, a method of using the same to treat and/or prevent a disease or disorder associated with a hepatitis virus, and a use of the same in the manufacture of a medicament for the treatment and/or prevention of a disease or disorder associated with a hepatitis virus or for the elimination and/or alleviation of a disease or disorder associated with a hepatitis virus.
  • Hepatitis or liver disease is usually caused by hepatitis virus.
  • Hepatitis viruses generally are divided into the following types: A, B, C, D, E and G, in which hepatitis B virus causes chronic diseases that are currently distributed worldwide and a considerable proportion of hepatitis B may turn into liver cancer in the later stage of disease development if it is not improperly controlled.
  • chronic hepatitis B treatment is to maximize the long-term inhibition of HBV replication, reduce inflammatory necrosis of liver cells and liver fibrosis, and delay and reduce liver failure and decompensation of liver cirrhosis, HCC and other complications, thereby improving quality of life and extending survival time.
  • the clinical cure of chronic hepatitis B should be pursued as much as possible, that is, after the end of treatment, there should be continuous virological response, HBsAg negative conversion or accompanied by anti-HBs positive conversion, normal ALT, mild or no lesions of liver tissues.
  • the complete healing means that except antibodies, HBV DNA, various antigens, and cccDNA are eliminated in body.
  • HBsAg surface antigen
  • NUCs nucleos(t)ide analogues
  • antiviral drugs approved by the FDA for the treatment of chronic hepatitis B infection, including ordinary and pegylated interferons and 5 oral nucleos(t)ide analogs (i.e., lamivudine, adefovir dipivoxil, entecavir, telbivudine, and tenofovir disoproxil fumarate (TDF)), in which entecavir (ETV) and tenofovir disoproxil fumarate are recommended as therapeutic first-line drugs (Liaw, Leung et al. 2008; Lok and McMahon 2009; Liu, Yang et al. 2014; Gish, Given et al. 2015).
  • the HBsAg negative conversion ratio was less than 5%; and for those showing response after receiving pegylated interferon (PEG-IFN) treatment, the HBsAg negative conversion ratio was less than 10% during long-term follow-up (Sundaram and Kowdley 2015).
  • NUCs drugs can only inhibit the synthesis of the viral positive and negative strands in nucleocapsids; during the antiviral therapy thereof, the mainly disappeared thing is replication DNA, and there is no direct effect on the cccDNA in the nucleus of liver cells and the viral antigens transcribed and expressed thereby (Wong, Seto et al. 2013).
  • IFN ⁇ Another class of drugs, IFN ⁇ , has both immunoregulatory and direct antiviral effects, and can induce the expression of APOBEC3A in HBV-infected liver cells, promote the degradation of cccDNA through base editing, and exert direct antiviral effects (Lucifora, Xia et al. 2014).
  • HBV can antagonize the IFN ⁇ signaling pathway, resulting in poor therapeutic effect of IFN ⁇ drugs (Bertoletti and Ferrari 2012). Therefore, given the limitations of current antiviral drugs, other therapeutic strategies such as stimulating and/or restoring antiviral immunity are currently hot-spots in researches for the clearance of chronic HBV infection (Lucifora and Trepo 2015).
  • a host-specific immune response is essential for HBV clearance.
  • the HBV-specific T-lymphocyte response is the most important effector cell to clear HBV infection in liver cells.
  • the viral genome can be repaired by host DNA polymerase to form a stable covalently closed circular DNA (cccDNA) and parasitized in nucleus of the liver cells.
  • cccDNA stable covalently closed circular DNA
  • the difficulty in removal of cccDNA microchromosomes is an important reason for the difficulty of cure in clinical antiviral treatment (Nassal 2015).
  • HBV effector T cells can directly kill infected liver cells, induce target cell apoptosis, and clear cccDNA and other viral products through the killing effects of granzymes, perforin, or the cytotoxic pathway of hepatocyte apoptosis induced by FasL (Hoh, Heeg et al. 2015).
  • cytokines such as IFN ⁇ and TNF ⁇ secreted by effector T cells can also affect infected liver cells and induce intracellular antiviral gene expression through non-cytolytic pathway to inhibit viral replication and cccDNA synthesis (Guidotti, Rochford et al. 1999).
  • the effector T cells can be anchored to the hepatic sinusoids through platelets, and directly contact infected liver cells presenting viral antigens through the endothelial cell gap, and then secrete cytokines such as IFN ⁇ and TNF ⁇ to directly induce the apoptosis of the infected liver cells so as to clear HBV (Guidotti, Inverso et al. 2015).
  • the B cells also play a very important role in controlling HBV infection.
  • the hepatitis B surface antigen antibody (HBsAb) produced by B cells can neutralize and block HBV infection of liver cells.
  • IAP proteins are a key class of apoptosis regulators and are characterized by the presence of one or more BIR (baculovirus IAP repeat) domains.
  • BIR Baculovirus IAP repeat
  • IAPs cellular IAP1 (cIAP1) and cIAP2 play a key role in the regulation of death receptor-mediated apoptosis
  • XIAP X-linked IAP
  • IAP proteins are highly overexpressed in both cancer cell lines and human tumor tissues, and have low expression in normal cells and tissues.
  • IAP proteins make cancer cells resistant to the apoptosis inducted by a variety of anticancer drugs.
  • a detailed discussion of IAP proteins and their effects on cancer as well as apoptosis is described in US Patent No. 7,960,372 .
  • IAP central negative regulator for apoptosis
  • This category includes proteins such as XIAP, cIAP1, cIAP2, ML-IAP, HIAP, KIAP, TSIAP, NAIP, survivin, livin, ILP-2, apollon, and BRUCE.
  • peptide-based inhibitors are useful tools to elucidate the anti-apoptotic function of IAP and the role of IAP in the response of cancer cells to chemotherapeutic agents.
  • the prior art does not disclose or suggest that the bisdiazabicyclo compounds are effective in inhibiting or eliminating hepatitis viruses, especially HBV viruses.
  • the inventors of the present application unexpectedly found that the bisdiazabicyclo compounds are extremely effective in inhibiting and/or eliminating hepatitis viruses, especially HBV virus.
  • a first aspect of the present invention relates to a bisdiazabicyclo compound for treatment and/or prevention of a disease or disorder associated with a hepatitis virus, wherein the compound is a bisdiazabicyclo compound.
  • the bisdiazabicyclo compound is a compound having the following structure or a pharmaceutically acceptable salt thereof:
  • R is
  • X is SO2 and Y is absent.
  • the compound is or
  • the compound is selected from: or
  • the disease or disorder associated with hepatitis virus is a disease or disorder associated with the late stage of infection with hepatitis virus.
  • the disease or disorder associated with hepatitis virus is a disease or disorder associated with hepatitis A virus, hepatitis B virus or hepatitis C virus.
  • the hepatitis virus-related disease or disorder includes, but is not limited to: hepatitis A, hepatitis B, hepatitis C, and liver cirrhosis.
  • the compound treats and/or prevents a disease or disorder associated with hepatitis virus by modulating an immune response.
  • a second aspect of the present invention relates to a use of the compound as defined above in manufacture of a medicament for treatment and/or prevention of a disease or disorder associated with a hepatitis virus.
  • a third aspect of the present invention relates to a method for treating and/or preventing a disease or disorder associated with a hepatitis virus, comprising administering a therapeutically and/or prophylactically effective amount of the compound to a patient suffering from the disease or disorder associated with the hepatitis virus, and the compound being a bisdiazabicyclo compound.
  • a fourth aspect of the present invention relates to a pharmaceutical composition
  • a pharmaceutical composition comprising the compound as defined above, wherein the pharmaceutic composition is useful in the treatment and/or prevention of a disease or disorder associated with a hepatitis virus.
  • C 4-8 aliphatic ring refers to a cyclobutyl, cyclopentyl, cyclohexyl, cycloheptyl or cyclooctyl unsubstituted or substituted by 1 to 3 groups (e.g., C 1-4 alkyl, halogen, trifluoromethyl, trifluoromethoxy, hydroxy, alkoxy, nitro, cyano, alkylamino or amino).
  • alkyl refers to a saturated C 1-10 hydrocarbon group in form of straight- or branched-chain, and its non-limiting examples include methyl, ethyl, and propyl, butyl, pentyl, hexyl, heptyl, octyl, nonyl and decyl in form of straight- or branched-chain.
  • C3-6 cycloalkylene refers to a disubstituted cycloalkane having 3 to 6 carbon atoms, for example, “C 3-6 cycloalkylene” may be unsubstituted or substituted with 1 to 3 groups, such as C 1-4 alkyl, halogen, trifluoromethyl, trifluoromethoxy , hydroxy, alkoxy, nitro, cyano, alkylamino or amino.
  • halogen as used herein is defined as fluorine, chlorine, bromine or iodine.
  • hydroxy as used herein is defined as -OH.
  • alkoxy as used herein is defined as -OR, where R is alkyl.
  • amino as used herein is defined as -NH 2
  • alkylamino is defined as -NR2, wherein at least one R is an alkyl group and the second R is an alkyl group or hydrogen.
  • nitro as used herein is defined as -NO 2 .
  • cyano as used herein is defined as -CN.
  • trifluoromethyl as used herein is defined as -CF 3 .
  • trifluoromethoxy as used herein is defined as -OCF 3 .
  • optionally substituted means being substituted with one or more, especially one to four, groups independently selected from, for example, halogen, alkyl, alkenyl, -OCF 3 , -NO 2 , -CN, -NC, -OH, alkoxy, amino, alkylamino, -CO 2 H, -CO 2 alkyl, alkynyl, cycloalkyl, nitro, mercapto, imino, amido, phosphonate, phosphinate, silyl, alkylthio, sulfonyl, sulfonamido, aldehyde, heterocycloalkyl, trifluoromethyl, aryl and heteroaryl.
  • aryl refers to a monocyclic or polycyclic aromatic group, preferably a monocyclic or bicyclic aromatic group, such as phenyl or naphthyl.
  • heteroaryl refers to a monocyclic or bicyclic ring system containing one or two aromatic rings and containing at least one and up to four nitrogen atoms in one of the aromatic rings.
  • disease or “disorder” means a disordered and/or abnormal condition that is generally considered as a pathological state or function, and can manifest itself in the form of specific signs, disorders, and/or malfunctions.
  • treating means eliminating, inhibiting, reducing or alleviating the disease or disorder
  • preventing means avoiding and obviate a disease or disorder, or preventing the disease or disorder from occurring or appearing.
  • the first aspect of the present invention relates to a bisdiazabicyclo compound, the compound is used for treatment and/or prevention, or elimination and/or alleviation of a disease or disorder associated with a hepatitis virus, wherein the compound is a bisdiazabicyclo compound.
  • the bisdiazabicyclo compound is a compound having the following structure or a pharmaceutically acceptable salt thereof:
  • R is
  • X is SO2 and Y is absent.
  • the compound is or
  • the bisdiazabicyclo compound is a compound having the following structure or a pharmaceutically acceptable salt thereof:
  • R is wherein p is 0 to 4.
  • R is wherein phenyl is optionally substituted by 1 to 4 groups independently selected from halogen, -OCF 3 , -NO 2 , -CN, -NC, -OH, amino, C 1-10 alkyl, C 1-10 alkyloxy and C 1-10 alkylamino.
  • R is
  • R 1 is wherein phenyl is optionally substituted by 1 to 4 groups independently selected from halogen, -OCF 3 , -NO 2 , -CN, -NC, -OH, amino, C 1-10 alkyl, C 1-10 alkyloxy and C 1-10 alkylamino.
  • R 1 is wherein phenyl is optionally substituted by 1 to 4 groups independently selected from halogen, -OCF3, -NO 2 , -CN, -NC, -OH, amino, C 1-10 alkyl, C 1-10 alkyloxy and C 1-10 alkylamino.
  • X is and Y is -NH-.
  • X is and Y is -NH-.
  • X is and Y is O.
  • the compound is selected from and
  • the compound is or
  • the compound is selected from or
  • the compound is SF18, which has the following structure:
  • the compound is Compound 1, that is, 1,3-benzene-di[7-(3S,5S,9aR)-5-((S)-2-methylamino-propionamido)-3-diphenylmethylaminocarbonyl-4-oxo-3a,7-diaza-decahydrocyclopentanocyclooctene)]-sulfonamide, having the following structure:
  • the compound is obtained according to the preparation method disclosed in PCT/US2013/055384 ( WO2014/031487 ), the entire contents of which are incorporated herein by reference.
  • the compound of the present invention can be used in the form monomer or composition. Further, the compound of the present invention can be administered to a patient in need of treatment via intestinal, parenteral or topical route.
  • the intestinal route usually includes oral administration
  • the form of the compound of the present invention for intestinal route use includes oral solutions, tablets, capsules, granules, and suspensions.
  • the parenteral route usually includes subcutaneous, intramuscular, intraperitoneal, intravenous routes, etc.
  • the form of the compound of the present invention for parenteral route use includes injections and lyophilized preparations.
  • the form of the compound of the present invention for topical use includes patches, pastes, ointments, etc.
  • the disease or disorder associated with hepatitis virus is a disease or disorder associated with the late stage of hepatitis virus infection;
  • the disease or disorder associated with hepatitis virus is a disease or disorder associated with hepatitis A virus, hepatitis B virus, or hepatitis C virus;
  • the disease or disorder associated with hepatitis virus includes, but is not limited to: hepatitis A, hepatitis B, hepatitis C, and/or liver cirrhosis.
  • the compound treats and/or prevents a disease or disorder associated with a hepatitis virus by modulating an immune response.
  • the immune response is involved in a specific T-cell response to a hepatitis virus (including, but not limited to, hepatitis A virus, hepatitis B virus, and hepatitis C virus, particularly hepatitis B virus). More preferably, the immune response is involved in the secretion of IFN ⁇ , TNF ⁇ , IL-2 in CD4+ T cells and CD8+ T cells.
  • the second aspect of the present invention relates to a use of a bisdiazabicyclo compound in manufacture of a medicament for treatment and/or prevention, or elimination and/or alleviation of a disease or disorder associated with a hepatitis virus.
  • the compound is a compound as defined above.
  • the medicament includes a known drug for treatment of hepatitis virus, especially HBV, in which the drug includes, but is not limited to: IFN ⁇ -2a, Birinapant, anti-PDl antibody, pegylated interferon ⁇ 2b, pegylated interferon ⁇ 2a, lamivudine, adefovir, entecavir and/or tenofovir (in particular, tenofovir disoproxil fumarate).
  • the disease or disorder associated with a hepatitis virus is a disease or disorder associated with the late stage of hepatitis virus infection; the disease or disorder associated with hepatitis virus is a disease or disorder associated with hepatitis A virus, hepatitis B virus, or hepatitis C virus; preferably, the disease or disorder associated with hepatitis virus includes, but is not limited to: hepatitis A, hepatitis B, hepatitis C, and/or liver cirrhosis.
  • the medicament treats and/or prevents a disease or disorder associated with a hepatitis virus by modulating an immune response.
  • the immune response is involved in a specific T-cell response to a hepatitis virus (including, but not limited to, hepatitis A virus, hepatitis B virus, and hepatitis C virus, particularly hepatitis B virus). More preferably, the immune response is involved in the secretion of IFN ⁇ , TNF ⁇ , IL-2 in CD4+ T cells and CD8+ T cells.
  • the third aspect of the present invention relates to a method for treating and/or preventing, or eliminating and/or alleviating a disease or disorder associated with a hepatitis virus, the method comprising administering a therapeutically and/or prophylactically effective amount of the compound to a patient suffering from the disease or disorder associated with the hepatitis virus.
  • the compound is a compound as defined above.
  • the compound can be further used in combination with a known drug for treatment of hepatitis virus, especially HBV, in which the known drug for treatment of hepatitis virus, especially HBV, includes, but is not limited to: pegylated interferon ⁇ 2b, pegylated interferon ⁇ 2a, lamivudine, adefovir (in particular, adefovir dipivoxil), entecavir and/or tenofovir (in particular, tenofovir disoproxil fumarate).
  • the compound when used in combination with the drug known for treatment of hepatitis virus, especially HBV, the compound and the drug known for treatment of hepatitis virus, especially HBV, can be administered together, separately and sequentially.
  • the disease or disorder associated with a hepatitis virus is a disease or disorder associated with the late stage of hepatitis virus infection; the disease or disorder associated with hepatitis virus is a disease or disorder associated with hepatitis A virus, hepatitis B virus, or hepatitis C virus; preferably, the disease or disorder associated with hepatitis virus includes, but is not limited to: hepatitis A, hepatitis B, hepatitis C, and/or liver cirrhosis.
  • the compound treats and/or prevents a disease or disorder associated with a hepatitis virus by modulating an immune response.
  • the immune response is involved in a specific T-cell response to a hepatitis virus (including, but not limited to, hepatitis A virus, hepatitis B virus, and hepatitis C virus, particularly hepatitis B virus). More preferably, the immune response is involved in the secretion of IFN ⁇ , TNF ⁇ , IL-2 in CD4+ T cells and CD8+ T cells.
  • the fourth aspect of the present invention relates to a pharmaceutical composition
  • a pharmaceutical composition comprising a bisdiazabicyclo compound, the pharmaceutical composition is used for treatment and/or prevention, or elimination and/or alleviation of a disease or disorder associated with a hepatitis virus.
  • the bisdiazabicyclo compound is a compound as defined above.
  • the pharmaceutical composition can further comprise a known drug for treatment of hepatitis virus, especially HBV, in which the known drug includes, but is not limited to: interferon ⁇ 2b, interferon ⁇ 2a, lamivudine, adefovir (in particular, adefovir dipivoxil), entecavir and/or tenofovir (in particular, tenofovir disoproxil fumarate).
  • the disease or disorder associated with a hepatitis virus is a disease or disorder associated with the late stage of hepatitis virus infection; the disease or disorder associated with hepatitis virus is a disease or disorder associated with hepatitis A virus, hepatitis B virus, or hepatitis C virus; preferably, the disease or disorder associated with hepatitis virus includes, but is not limited to: hepatitis A, hepatitis B, hepatitis C, and/or liver cirrhosis.
  • the compound treats and/or prevents a disease or disorder associated with a hepatitis virus by modulating an immune response.
  • the immune response is involved in a specific T-cell response to a hepatitis virus (including, but not limited to, hepatitis A virus, hepatitis B virus, and hepatitis C virus, particularly hepatitis B virus). More preferably, the immune response is involved in the secretion of IFN ⁇ , TNF ⁇ , IL-2 in CD4+ T cells and CD8+ T cells.
  • a chronic HBV infection mouse model was established using C57BL/6J mice by high-pressure tail vein injection of pAAV-HBV1.2 plasmid to simulate chronic hepatitis B patients which could obtain immune control spontaneously.
  • Male C57/B6 mice (6-8 weeks of age, body weight 20 ⁇ 2g) were selected to establish a high-pressure tail vein injection mouse model, in which the tail of mice was wiped with 75% alcohol, and then irradiated with a far-infrared physiotherapy device for 2 to 3 minutes so that the tail vein of mice was turgid and clearly visible.
  • a needle was inserted in parallel along the tail vein, until feeling empty or seeing blood return, which indicated that the needle entered into the vein, and then the injection was completed within 10s by gently pushing.
  • mice were injected with 10 ⁇ g of pAAV/HBV1.2 plasmid, and the amount of injection liquid (PBS) was 10% of body weight (2 mL/20 g).
  • PBS injection liquid
  • blood was collected to detect HBsAg, and the successfully modeled mice with HBsAg > 500 IU/ml were selected for further experiments (Huang, Wu et al. 2006; Chou, Chien et al. 2015).
  • mice After C57BL/6J mice were successfully modeled, they were divided into 4 groups: 0.9% NaCl saline injection group (Group 1 in Figures 1A and 1B , black lines), Compound 1 10 mg/kg intravenous injection group (Group 2 in Figures 1A and 1B , red lines), Compound 1 20 mg/kg intravenous injection group (Group 3 in Figures 1A and 1B , blue lines). There were 6-8 mice in each group, which were administered once a week for 4 consecutive times and observed for 7 weeks.
  • mice serum were diluted 20-fold with PBS, the HBsAg and HBeAg titers of the serum were detected by using Abbott i2000SR microparticle chemiluminescence automatic detector.
  • the serum HBV DNA was extracted by QIAamp DNA Mini Kit (Qiagen), the HBV DNA level in serum was quantified by Realtime-PCR (LightCycler 480, Roche) using DNA Amplification SYBR Green Kit (Roche), and the HBV plasmid PSM2 products with a series of concentration gradients were used as standards.
  • HBV primers used in this experiment were synthesized by Invitrogen (Shanghai) Trading Co., Ltd., and the primer sequences were as follows: HBV Hope-F (5 ' to 3' TACTAGGAGGCTGTAGGCATA) and HBV Hope-R (5' to 3' GGAGACTCTAAGGCTTCCC).
  • HBV Hope-F 5 ' to 3' TACTAGGAGGCTGTAGGCATA
  • HBV Hope-R 5' to 3' GGAGACTCTAAGGCTTCCC.
  • the liver tissues of mice were subjected to conventional formalin-fixation and paraffin-embedding, the resultant 4 ⁇ m sections were baked at 65°C for 2h, dehydrated with conventional ethanol gradients, infiltrated with hydrogen peroxide at room temperature for 30min, washed with PBS for 5min/time, 3 times in total, and blocked at room temperature for 1h.
  • liver tissue homogenate 60 mg was weighed, added with 900 ⁇ l of lysate (50 mmol/L Tris-HCl PH 7.5 + 1 mmol/L EDTA), placed on ice, and after all samples were processed, 5 ⁇ l of NP-10 was added and lysis was performed on ice, and then HBV DNA in liver tissue was extracted with phenol/chloroform, dissolved by adding 15 ⁇ l of RNase free water, run on a 1% agarose gel, transferred to membrane; then a full-length HBV probe labeled with digoxin was added, stood overnight at 46 °C, subjected to DIG Washing Buffer once for 5min, added with Anti-Digoxigenin-Ap Fab fragment (11093274910, Roche), and Image Quant LAS 4000mini was used for exposure and detection.
  • lysate 50 mmol/L Tris-HCl PH 7.5 + 1 mmol/L EDTA
  • Graphpad Prism 5.0 was used for mapping and relevant statistical analysis, Kruskal-Wallis H test and Dunn's Multiple Comparison test were used for multiple comparisons between groups at the same time point, log-rank Mantel-Cox test was used to compare the HBsAg and HBV DNA clearance rates in serum, * represented P ⁇ 0.05, ** represented p ⁇ 0.01, and *** represented p ⁇ 0.001, in which P ⁇ 0.05 indicated a statistically significant difference.
  • the Compound 1 injection groups showed rapid decrease in serum HBsAg ( Figure 1A ) and serum HBV DNA ( Figure 1B ) after administration, and both of the serum HBsAg and HBV DNA were below the detection limit up to the 7 th week, in which the Compound 1 20 mg/kg injection group indicated that serum HBsAg and HBV DNA were completely eliminated on the 5 th week, which was faster than that of the Compound 1 10 mg/kg dose group.
  • liver tissue HBcAg immunohistochemical staining results showed that HBcAg expression was not observed in the liver of the mice of the Compound 1 injection groups after 7 weeks of administration, but HBcAg expression in the liver of some mice in the normal saline control group could still be detected ( Figure 1C ).
  • the results of HBV DNA Southern blot in liver tissue 7 weeks after administration showed that no HBV replication intermediate was detected in the liver tissue of the Compound 1 injection group as compared with the saline group ( Figure 1D ).
  • the C57BL/6J mouse model was established by pAAV-HBV1.2 plasmid high-pressure tail injection.
  • C57BL/6J mice (6 to 8 weeks of age, body weight 20 ⁇ 2g) were successfully modeled and divided into 4 groups, i.e., 0.9% NaCl intravenous injection group (Group 1 in Figures 2A and 2B , black lines), Compound 1 10 mg/kg intravenous injection group (Group 2 in Figures 2A and 2B , red lines), TDF 53 mg/kg gavage group (Group 3 in Figures 2A and 2B , blue lines), Compound 1 10mg/kg in combination with TDF 53mg/kg administration group (Group 4 in Figures 2A and 2B , purple lines).
  • mice There were 6 to 8 mice in each group, Compound 1 was injected once a week for 4 consecutive times, TDF was gavaged every day for a total of 10 days, and the mice were observed for 7 weeks. Serological HBsAg and HBV DNA detection methods were the same as above.
  • Chronic HBV infection mouse models were established by high-pressure tail vein injection of pAAV-HBV1.2 plasmid or recombinant virus rAAV8-1.3HBV injection of C57BL/6J mice (6 to 8 weeks of age, weight 20 ⁇ 2g). After C57BL/6J mice were successfully modeled by high-pressure tail vein injection of pAAV-HBV1.2 plasmid, the mice were injected intravenously with Compound 1 at 10 mg/kg, and serum and liver tissues of the mice were collected at 12, 24, and 48 hours after injection.
  • AST/GOT Glutamic-oxalacetic transaminase
  • ALT/GPT glutamic-pyruvic transaminase
  • Western blot was used to detect the expression of cIAPs molecules in liver tissues, and ⁇ -actin was used as a control. Intrahepatic inflammation and hepatocyte necrosis were detected by HE staining of liver tissue sections.
  • C57BL/6J mice were subjected to conventional tail vein injection of rAAV8-1.3HBV (ayw) virus at viral injection amount of 5 ⁇ 10 5 v.g./mice (Yang, Liu et al. 2014) to establish the rAAV8-HBV1.3 virus injection C57BL/6J mouse model; the mice were sacrificed 12 hours after the intravenous injection of Compound 1 at 20 mg/kg, and the HBV-infected hepatocyte apoptosis was subjected to double staining detection of HBcAg immunofluorescence and Tunnel method.
  • liver tissue HE staining also showed that 12 hours after the injection, scattered necrotic lesions appeared in the vicinity of the portal areas in the liver tissue, accompanied by lymphocyte infiltration ( Figure 3C ).
  • the double staining experiment of Tunel staining and HBcAg fluorescence was used to observe the apoptosis of HBV-infected liver cells, and in combination with double-staining 3D picture analysis, it was found that 12 h after injection of Compound 1, the apoptosis of HBcAg-positive liver cells could be induced ( Figure 3D ).
  • Compound 1 could specifically induce the apoptosis of HBV-infected liver cells and contribute to the clearance of virus; in addition, it only induced transient intrahepatic inflammation and did not cause fulminant hepatitis, thereby reducing adverse reactions possibly caused by the treatment.
  • mice C57BL/6J mice (6-8 W week old, weight 20 ⁇ 2g) were subjected to high-pressure tail vein injection of pAAV-HBV1.2 plasmid to establish a chronic HBV infection mouse model. After the modeling was successful, the mice were divided into two groups: Group A: 0.9% NaCl biological saline injection group; Group B: Compound 1 20 mg/kg injection group. There were 5 to 6 mice in each group, which were administered once a week for four consecutive times, and sacrificed on the 7 th week, the mice liver lymphocytes were isolated, and cell counts and flow cytometry were used to detect the expression of CD4 and CD8 molecules in lymphocytes in the liver.
  • HBV-specific T cell response was performed by using HBV core monopeptide (Core93-100) to stimulate lymphocytes, and the counts of CD4+ and CD8+ T cells that secreted IFN ⁇ , TNF ⁇ and IL-2 were detected by flow cytometry cytokine intracellular staining method.
  • Chronic HBV infection mouse model was established using C57BL/6J mice (6 to 8 W, body weight 20 ⁇ 2g) that were subjected to the high-pressure tail vein injection of a mixture of pAAV-HBV1.2 plasmid and pKCMvint IFN ⁇ -2a plasmid or pKCMvint control plasmid (6 ⁇ g/mouse), and expressed IFN ⁇ 2a.
  • mice were divided into 4 groups.
  • Group A (0.9% saline injection group): pAAV-HBV1.2+pKCMvint+0.9%NaCl;
  • Group B Compound 1 10 mg/kg intravenous injection group: pAAV-HBV1.2+pKCMvint+Compound 1 10mg/kg;
  • Group C IFN ⁇ -2a group: pAAV-HBV1.2+pKCMvint IFN ⁇ -2a+0.9%NaCl;
  • Group D Compound 1 in combination with IFN ⁇ -2a group: pAAV-HBV1.2+pKCMvint IFN ⁇ -2a+APG 10 mg/kg.
  • mice There were 5 mice in each group (except Group D that included 7 mice), the administration was performed for consecutive 3 times, i.e., on the day 1 after modeling, and on the days 7 and 14 after modeling; blood was collected once at orbital margin one day before the administration, and serum HBsAg/HBeAg levels were detected using Roche 601 instrument.
  • the serum HBsAg and HBeAg levels were statistically different between different treatment groups on the 7 th , 14 th , and 21 st days after modeling.
  • the former 3 groups showed statistically significant differences in serum HBsAg on the 7 th , 14 th , and 21 st days, that was, the P value was 0.010 on the 7 th day, the P value was 0.008 on the 14 th day, and the P value was 0.004 on the 21 st day, in which a statistical difference between the groups was determined when P value was less than 0.05, and wherein the decrease of serum HBsAg in the combined treatment Group D was the most significant.
  • the former 3 groups showed statistically significant differences in serum HBeAg on the 7 th , 14 th , and 21 st days, that was, the P value was 0.004 on the 7 th day, the P value was 0.021 on the 7 th day, and the P value was 0.001 on the 21 st day, in which a statistical difference between the groups was determined when P value was less than 0.05, and wherein, the decrease of HBeAg in the combined treatment group D was the most significant.
  • the Compound 1 in combination with IFN ⁇ 2a group had the most significant effect in reducing HBsAg/HBeAg. Therefore, the Compound 1 in combination with IFN ⁇ 2a group had anti-HBV effect in the chronic HBV infection mouse model established in C57BL/6J mice by high-pressure tail vein injection of the mixture of pAAV-HBV1.2 plasmid and pKCMvint IFN ⁇ -2a plasmid or pKCMvint control plasmid.
  • mice C57BL/6J mice (6 to 8 weeks of age, weight 20 ⁇ 2g) were subjected to high-pressure tail vein injection of pAAV-HBV1.2 plasmid to establish a chronic HBV infection mouse model.
  • the mice were divided into 3 groups: Group A: 0.9% NaCl saline injection group; Group B: Compound 1 20 mg/kg intravenous injection group, and Group C: Birinapant 20 mg/kg intravenous injection group.
  • Group A 0.9% NaCl saline injection group
  • Group B Compound 1 20 mg/kg intravenous injection group
  • Group C Birinapant 20 mg/kg intravenous injection group.
  • Compound 1 and Birinapant were administered once a week for five consecutive weeks. Blood was collected at orbital margin each week before the administration, and the HBsAg/HBeAg levels in supernatant were detected using Roche 601 instrument.
  • mice C57BL/6J mice (6-8 weeks of age, weight 20 ⁇ 2g) were subjected to high-pressure tail vein injection of pAAV-HBV1.2 plasmid to establish a chronic HBV infection mouse model. After the modeling was successful, the mice were divided into 4 groups: Group A: 0.9% NaCl saline injection group; Group B: Compound 1 20 mg/kg intravenous injection group; Group C: anti-PD1 antibody 200 ⁇ g/mice/time peritoneal injection group; Group D: Compound 1 in combination with anti-PD1 antibody group. Among them, there were 7 mice in each group. Compound 1 was administered intravenously once per week, and anti-PD1 antibody was administered intraperitoneally twice per week. Blood was collected from the orbital margin before the administration of Compound 1 every week, and the HBsAg/HBeAg levels in the supernatant were detected using a Roche 601 instrument.
  • the Compound 1 single group and the Compound 1 in combination with anti-PD1 antibody administration group could significantly reduce serum HBsAg/HBeAg levels.
  • the anti-PD1 antibody single group showed no significant decrease in the HBsAg/HBeAg effect.
  • the serum HBsAg of Group D decreased more significantly on the 2 nd and 3 rd weeks after administration, and the P values were 0.015 and 0.037, respectively (the P values of separate comparisons for the both in the weeks 2 and 3 were not shown in the figures).
  • the 3 groups of different drugs showed statistically significant differences in serum HBeAg on the 1 st and 2 nd weeks, that was, the P value was 0.029 on the 1 st week, the P value was 0.009 on the 2 nd week, and a statistical difference between the groups was determined when P value was less than 0.05.
  • the serum HBeAg levels of Group B and Group D decreased more significantly on the 1 st and 2 nd weeks after administration, the P values on the 1 st week were 0.016 and 0.007 respectively, and the P values on the 2 nd week were 0.007 and 0.002 respectively (the P values of separate comparisons for the both on the 1 st and 2 nd weeks were not shown in the figures), but there was no statistical difference between Group B and Group D.
  • mice were subjected to conventional tail vein injection of rAAV8-HBV1.3 (ayw) virus, the injection volume of virus was 5 ⁇ 10 5 vg/mouse (Yang, Liu et al. 2014), and thus rAAV8-HBV1.3 virus injection C57BL/6J mouse model was established.
  • the mice were divided into three groups: Group A: 0.9% NaCl saline injection group; Group B: Compound 1 20 mg/kg intravenous injection group, and Group C: SF18 20 mg/kg intravenous injection group. Among them, there were 3 mice in each group.
  • Administration was carried out for consecutive four weeks, blood was collected at orbital margin once per week, and HBsAg/HBeAg levels in supernatant were detected by Roche 601 instrument.

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